The applicant's immediate research career goals are to explicate the illness representations of elderly individuals with end-stage renal disease (ESRD) and to examine the effect of illness representations on functioning in these individuals. The applicant's longterm research goals are to develop and test the effectiveness of interventions designed to alter illness representations and stop or reverse functional decline in elders with ESRD. To meet these goals, the applicant has proposed a plan of comprehensive, mentored training and research in theoretical perspectives related to aging, aging and functional decline, and aging research, as well as an application of this knowledge to a program of research tailored to illness representations in chronically ill elders. Mentors will be Dr. Howard Leventhal and Dr. Neville Strumpf. The proposed research and training environments are: 1) The Institute of Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey; 2) The Center for Gerontologic Nursing Science, University of Pennsylvania School of Nursing; and 3) The College of Nursing, Rutgers, The State University of New Jersey. Training activities will consist of didactic course work, pre-planned mentor meetings, participation in ongoing seminars, research and scientific meetings, directed readings, and scientific publications and presentations. The aims of the proposed studies are 1) to insure that the terminology used in the Illness Perception Questionnaire matches the experience of ESRD for elderly patients; 2) to explicate the illness representations of elderly ESRD patients; and 3) to examine the effect of their illness representations on their level of functioning. The findings from these studies will be used to support a program of theory-based, tailored, psycho-educational nursing intervention studies designed to alter illness representations and stop or reverse functional decline in elders with ESRD.